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This made me think of the "Agents of SHIELD" episode where Mac asks Phil "You want a beer?" and Coulson says, "It's 6am! Who are you, Hemingway?"Is 9 AM on Monday morning too early to start drinking?
Too, too funny
HEALTH
TV documentary on pain treatment funded by doctor with industry ties
DAVID ARMSTRONG @DavidArmstrongX
MARCH 24, 2017
VIA YOUTUBE
P
ublic television stations across the country have begun airing a documentary about pain treatment produced by a doctor with significant financial ties to the manufacturers of opioid medications — a fact not disclosed in the program.
“The Painful Truth” chronicles the plight of several patients struggling to find effective treatment for chronic pain. Throughout the 57-minute-long program, politicians, federal agencies, and others are depicted as having overreacted to the epidemic of opioid-related overdoses; the documentary suggests pain specialists have been discouraged from prescribing opioids to patients who genuinely need them.
The program accuses the US Drug Enforcement Agency of unfairly targeting pain doctors and putting a “bounty” on pain clinics the agency aims to shut down.
“The political culture has declared war against opioids and those who prescribe them,” the narrator of the program says. “The DEA is the army. The pain patients are the civilians caught in the middle.”
The producer, Dr. Lynn Webster of Utah, and several of the experts he quotes in the program, have long-standing and extensive financial relationships with pain medicine makers. When asked why these relationships are not disclosed to viewers, Webster told STAT that he did not receive any drug industry funding for the documentary. He said it was funded entirely by himself and his wife.
“I am cognizant of that issue, but I think I dealt with it as carefully as I could,” he said in an interview. If viewers want to know whether any of the individual doctors associated with the documentary have financial relationships with pharmaceutical makers, Webster said they can search for that information on the web.
No, Lynn isn't interested in doing what's right or he would have done it long ago. If you are such an unabashed proponent of a therapy that hasn't been studied - chronic opioids for chronic non-cancer pain - you
find a way to fund a powerful RCT of the drugs for a year or so and report the findings in a peer-reviewed journal. He never did that and he's still an advocate for the therapy in spite of 20 deaths due to it in his own
practice. It amazes me that he hasn't done jail time.
Are u actually defending someone who has had 20 overdose deaths and has had a 3 year investigation by the DEA as being "fair and unbiased"?
The guy who said that those deaths were probably from the staff (ie his NPs and PAs) and not his own personal scripts?
That many of these patients committed suicide?
That had Perry Fine be the one his attorney hired to review his opioid practice? Imagine a former AAPMed chair reviewing another one...
Who is supposedly sold his practice to do research, and has not produced any since doing so in 2013?
Whose practice was bought out and about 1/2 of his patients left within 2 years because the new guy reviewed and sometime reduced dose?
Deaths Trigger DEA Probe of Pain Specialist
Sent from my iPhone using SDN mobile
Webster's rai·son d'ê·tre has always been high dose opioids for that subset of patients - like those portrayed in his pro-opioid advertisement flick - who no one else will treat due to their psychiatric comorbidities, clear drug seeking behavior, and pain catastrophizing. He is the doctor that you think of when you think of
adverse risk selection. Some of this is narcissism - as with Hurwitz - as he clearly get's off on envisioning himself as Joan of Arc or Albert Schweitzer
for the sketchy pain patients who fawn over him. But, unlike Hurwitz Webster has been a paid consultant for opioid companies for years. Thus, his narcissism alone doesn't explain his opioid advocacy, he's a paid advocate (who$e). He is much worse than Hurwitz in that regard, and he should be in jail.
Webster's deep, deep involvement with opioid advocacy, Pharma, and the AAPM, have given him ample opportunity to talk about the need for, and then coax an opioid manufacturer into, a long term RCT to assess risk and benefit. But he not only never pursued that opportunity, he never mentions it. He doesn't because he knows that tolerance, dependence, and addiction would quickly emerge as adverse events and the trial would be abandoned early. He will be remembered as a pariah in pain medicine, a Pharma shill who never had the courage or insight to issue a mea culpa.
(so he is actually supposed to be putting all that money to use with research on opioids. i see some articles on pubmed, but most seem to deal with abuse potential of a new drug/way of giving the drug.)In Utah, ProPublica's data also spotlight a multimillion dollar industry of contract research organizations, or CROs, private companies that drug makers pay to test their drugs.
Among them is CRI LifeTree Research, which has received at least $3.4 million in drug company payments since 2009, according to ProPublica.
Co-founder Lynn Webster, an anesthesiologist, is listed as having received the single largest payment in the state: $1,687,771 from Cephalon, a big maker of pain medications. Only three other doctors in the country received more from Cephalon.
Nationally, Webster is among the top 50 for single largest payments received, behind marquee hospitals, such as the Mayo Clinic, Cleveland Clinic and Duke and Harvard Universities.
A nationally recognized expert in pain management, Webster is under investigation by the U.S. Drug Enforcement Administration, which is looking into opioid overdose deaths of patients of his former pain clinic. A Senate Committee is probing his financial ties to Big Pharma.
Webster no longer sees patients, but serves as a medical director at LifeTree's South Salt Lake location. Research payments to him cover overhead and other costs, including his salary as a lead researcher, he said.
"It is not the drug"
That's denial and it's BS.
I haven't changed anything. You rationalize opioid Rx'ing for CNP because that's what Rob taught you. The fruit doesn't fall far from the tree.
BTW, where's mini me lately?
im not understanding the "benefit" of this study.Long-Term Opioid Contract Use for Chronic Pain Management in Primary Care Practice. A Five Year Experience
Weak to moderate data, but still data.
im not understanding the "benefit" of this study.
not to be negative, but it was a retrospective cohort study, so tenuous conclusions at best.
what i got out of the study - maybe this is what you are looking for? - was that it was pretty crappy.
- only people who volunteered were included in the study. apparently, you could still get your opioids if you did not volunteer.
- only 42% of patients (n=104) got UDS done, and of them, a whopping 38% among those tested had illicit drugs (53 patients) . 18% was cocaine, 24% marijuana, and 6% both. of these 42%, only 50% had their "contract" cancelled because of illicit substance use, meaning 50% of the time it was ignored/remediated.
specifically - of those patients that the physicians cancelled - 54 patients - only 27 was due to a + UTS. only 4 other patients were cancelled due to "rules violations". 14 were discontinued for "prescription drug abuse" which may represent overuse. hard to tell, not specifically stated.
- with that in mind, no documentation if pill counts were done, but apparently no patients were fired for negative UDS, but there is no documentation that there were any negative UDS.
im not sure how that forwards the argument that addiction rate is low.
perhaps maybe we should advance this position - irrespective of the addiction rate (high or low), there is a significant portion of patients without sufficient benefit and with concurrent significant risks/complications from COT that such treatment should not be offered to them.
Its not the diabetes, its the sugar. I say we ban all sugar, products, cane. DM cured. Millions of lives saved.
On a separate note, I don't remember a Trolley Square mass shooting. That is a crazy story - all over in 6 minutes.
I love SLC.